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WHO develops global norms and standards for STI treatment and prevention, strengthens systems for surveillance and monitoring, including those for drug-resistant gonorrhoea, and leads the setting of the global research agenda on STIs.
The objective of this Checklist is to support women living with HIV and community activists who care about the rights of women living with HIV to guarantee effective implementation of the WHO Consolidated guideline on sexual and reproductive health and rights of women living with HIV. This is important given that uptake of the guideline includes the meaningful engagement of women living with HIV in all their diversity.
These Guidelines for Addressing HIV in Humanitarian Settings aim to assist humanitarian and AIDS organizations to plan the delivery of a minimum set of HIV prevention, treatment, care and support services to people affected by humanitarian crises.
These guidelines concentrate on the integration of HIV into the humanitarian response to crises, with a particular focus on two phases: the minimum initial response, which outlines a set of HIV-related interventions to be carried out during the early stages of any emergency regardless of the specific local or epidemiological context of the epidemic; and the expanded response, during which additional core HIV interventions should be planned and implemented as soon as possible, taking into account the local contexts and priorities, the epidemiological profiles and the capacity of different sectors to deliver the interventions.
The publication provides information on contraceptive options and choice, the medical eligibility criteria for different methods of contraception for women and adolescent girls living with HIV and using antiretroviral therapy, a summary of the comparative effectiveness of contraceptive methods and contraceptive considerations at different stages of a woman’s life-course.
Compared with clinical or immunological monitoring, viral load provides an early and more accurate indication of treatment failure. Measuring viral load can help to distinguish between drug resistance and non-adherence when coupled with robust enhanced adherence counselling. Further, viral load can serve as a proxy measure for the risk of transmission and effectiveness of prevention interventions at both the individual and population levels.
Increasing scale-up of treatment monitoring approaches through viral load testing as well as infant diagnosis will be critical to ensure high-quality care and treatment as well as programmatic success.
The objective of this brief is to consolidate WHO guidance to support the implementation of high-quality HIV services through approaches to policy, strategy and service delivery, to suggest considerations for selecting measures of high-quality services and to provide case examples of quality management in HIV services in low- and middle- income countries.
The rise in antimicrobial resistance (AMR) is one of the greatest threats to global health. If it is not urgently addressed, it may result in millions of deaths, an increase in new and hard-to-treat infections and increased health-care costs. As a result, combatting AMR, including the threat posed by drug-resistant HIV, is a major goal for the global community.
Prevention, monitoring and timely response to population levels of HIV drug resistance (HIVDR) is critical to achieving the WHO/UNAIDS 90–90–90 targets for 2020 that 90% of people living with HIV know their HIV status, 90% of those who know their HIV-positive status are accessing treatment and 90% of the people receiving treatment having suppressed viral loads.
Keywords: HIV, antimicrobial resistance (AMR), drug resistance (HIVDR), treatment
These guidelines provide further reassurance of DTG as the preferred antiretroviral (ARV) drug in first- and second-line regimens due to the declining estimate of neural tube defect risk and observed efficacy. This reassurance comes at a time when pretreatment resistance to non-nucleoside reverse-transcriptase inhibitors (NNRTI) is increasing in low- and middle-income countries, creating demand for access to alternative non-NNRTI ARV drugs.
After years of neglect, greater global attention is being paid to the increasing incidence of sexually transmitted infections (STIs). A recently published WHO report highlights that, annually, there are an estimated 376 million new cases of four curable STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. The need for greater focus on STIs has also been highlighted in the context of expanded use of pre-exposure prophylaxis (PrEP) for HIV prevention, where high STI prevalence at baseline and incidence during PrEP use have been observed. The epidemiological situation demands a call to action to ensure that these STIs are addressed, and that populations at risk have access to comprehensive STI prevention and care.
Integration of STI services and PrEP has challenges, but it also provides an opportunity not only to induce much- needed progress in STI control, but also to optimize broader sexual and reproductive health services for key, underserved and overlooked populations.
An increasing number of countries are adopting policies endorsing PrEP for HIV prevention. Emerging evidence from clinical research that different dosing strategies can be effective provides an opportunity to offer flexibility, choice and convenience to individuals who can benefit from PrEP and is considered by WHO in updating its guidance to countries. Based on the available evidence published so far, this technical brief updates the current WHO recommendation on oral PrEP to include an option of event-driven dosing for men who have sex with men.